HomeMy WebLinkAboutADD - OTH Address Requests - 12/15/1997 DEPARTMENT OF COMMUNITY DEVELOPMENT-PLANNING DIVISION
P.O. Box 578, Shelton, WA 98584
DGenie McFarland-Addressing, Ext. 291
O� There is a $5.00 fee for all new addresses issued.
Please allow 5 to 10 working days.
P/-110
OTC PNc���N Address Request Form 4�-646
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Name: �l/i/4 R L—..
Last First M.I.
Mailing Address: 20 0 , 8a X l 77 S u4y .. i 8rsw el
Street City State Zip
Day or Message Phone: (.7.21 Y-n-dS-r2
Parcel No: y/2/o /1 fr - 715-d/o /4 / 9/O
Legal Description: 4 d fit- q O F 14 -- / D V
Please draw a diagram of your property including nearest existing named road and nearest existing
address. Draw your house and driveway; indicate northerly direction. Please have your driveway signed
or marked for easy identification. All above information is required to process your request.
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im 5t/CG9 -7 0b(63
FOR OFFICE USE ONLY BELOW THIS LINE
Your New Address Is: _ �� E �ll OzLr- ML n fl ici
IMPORTANT: Please place, within 60 days, your assigned address number in a conspicuous location on
your structure if visible from the named road; or at the principal place of access (driveway entrance) if the
house is not visible from the named road. This will allow the most timely service in case of emergency.
In addition, please post the address with the building permit when construction begins on the site.
Received: —'�4-�/ Logged CTidemark: f� I¢ Answered: Iol 1,�1(Fire District I